RWC Series: "Facing Challenges from Around the Globe: Covid-19"
By Maria Berrocal , Director Berrocal & Associates, (San Juan, Puerto Rico)
ASRS, Retina Society, Pan-American Vitreo-retinal Society, Euretina, PACORES research group, Women in Retina, Women in Ophthalmology, Pan-American Ophthalmological Society, Puerto Rico Ophthalmological Society
Conditions where I live :  Puerto Rico has been in lockdown for 10 days now, and this will likely expand for 2 more weeks. Our initial cases were from foreign passengers on cruise ships, but now we have 65 confirmed cases – the testing has been slow. Everyone is quarantined except essential personnel and no one is allowed on the streets from 9 pm to 5 am due to curfew. Fines of $5,000 and arrests for violating the curfew are strictly enforced. This has been very effective. All restaurants, bars, hotels, beaches, and parks are closed. Restaurants do takeout and deliveries, and groceries and drugstores are open. Only one airport is open and everyone is temperature checked and ordered to quarantine if there is any suspicion of infection. We have limited health resources and an old population, so avoiding a large surge of cases/hospitalizations is the key to preventing a total catastrophe. We live on an island and no one can drive to another hospital.

I am seeing emergencies, injections and postoperative patients in the morning wearing gloves, masks, and shields. The patients come in serially and wait in their cars until we call them to minimize conglomeration. All elective procedures have been cancelled. We are doing in-office procedures and pneumatic retinopexies whenever possible. This situation underscores the need to have an armamentarium of in-office options to offer our patients as well as longer duration treatments that reduce the burden of monthly injections.

The other thing I have done is give my mobile phone number to all my patients by leaving it on the answering machine message at the office, and I have also shared my personal email address on my website. That way patients do not feel abandoned; they have enough anxiety and fear already. Though all my postop and injection patients have my mobile number, I really only get a few calls, but it is priceless that they know they can always reach me if they need me. My husband is an oncologist, and goes to the hospital daily where everyone is temperature screened but also wishes there was more widespread testing of healthcare personnel.

On the lighter side of things I have been using everything in my freezer! Ideally, if we had massive testing availability we would be able to better assess the extent of contamination among the population and particularly among hospital personnel. Our lack of real information about this really makes social distancing the only real option. Opening up the economy, like Singapore and Taiwan and Korea is only possible if massive testing is carried out, and we have data of previously asymptomatic patients who are now immune.
Retina World Congress encourages you to tell us about your experiences. If you would like to share your thoughts with the RWC community of retina societies, please contact us at .